BASIC PISTOL-LTC-002

REGISTRATION FORM
Please fill out form and return to me with check for $100     PAID _______________________
Private classes available for $125.00 in Easton, MA. Contact me for scheduling and detail.


DATE / COURSE_______________   DATE / BIRTH _____________________________

Please print carefully so your name will be correct on your certificate.

 NAME____________________________________________________________________
               First                                        MI                                Last 

STREET___________________________________________________________________

TOWN________________________________________ STATE_______ZIP___________

E-MAIL______________________________ TEL_________________________________

NRA MEMBER #______________________ GOAL # _____________________________
 

ANY PREVIOUS FIREARMS EXPERIENCE ______________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

SIGNATURE__________________________________________________

Mail to
Charles Davis
P.O. Box 981
Easton, MA 02334

cell 508-364-0544 or 508-238-1586



Instructor Certifications: MSP #BFS00262, NRA #7751050

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